Informed consent for emergency contraception: variability in hospital care of rape victims

Abstract

There is growing concern that rape victims are not provided with emergency contraceptives in many hospital emergency rooms, particularly in Catholic hospitals. In a small pilot study, we examined policies and practices relating to providing information, prescriptions, and pregnancy prophylaxis in emergency rooms. We held structured telephone interviews with emergency department personnel in 58 large urban hospitals, including 28 Catholic hospitals, from across the United States. Our results showed that some Catholic hospitals have policies that prohibit the discussion of emergency contraceptives with rape victims, and in some of these hospitals, a victim would learn about the treatment only by asking. Such policies and practices are contrary to Catholic teaching. More seriously, they undermine a victim's right to information about her treatment options and jeopardize physicians' fiduciary responsibility to act in their patients' best interests. We suggest that institutions must reevaluate their restrictive policies. If they fail to do so, we believe that state legislation requiring hospitals to meet the standard of care for treatment of rape victims is appropriate.

Services for victims of sexual violence.

“…Espey and colleagues' (2009) survey of hospitals in a state with a mandated emergency contraception law found that only 52% of the responding emergency departments routinely provide emergency contraception to sexual assault patients. To date, no studies have found systematic differences in the provision of emergency contraception as a function of victim or assault characteristics, but Catholic hospitals are significantly less likely to provide emergency contraception (Smugar, Spina, & Merz, 2000).…”

2008 award winners.

“…The American Medical Association (1995) and the American College of Obstetricians and Gynecologists (1998) recommend emergency contraception for victims at risk for pregnancy, but only 21% to 43% of sexual assault victims who need emergency contraception actually receive it (Amey & Bishai, 2002;Campbell, 2005Campbell, , 2006Campbell & Bybee, 1997;. To date, no studies have found systematic differences in the provision of emergency contraception as a function of victim or assault characteristics, but hospitals affiliated with the Catholic church are significantly less likely to provide emergency contraception (Campbell & Bybee, 1997;Smugar, Spina, & Merz, 2000).…”

Award for distinguished senior career contributions to psychology in the public interest: Philip G. Zimbardo.

“…The American Medical Association (1995) and the American College of Obstetricians and Gynecologists (1998) recommend emergency contraception for victims at risk for pregnancy, but only 21% to 43% of sexual assault victims who need emergency contraception actually receive it (Amey & Bishai, 2002;Campbell, 2005Campbell, , 2006Campbell & Bybee, 1997;. To date, no studies have found systematic differences in the provision of emergency contraception as a function of victim or assault characteristics, but hospitals affiliated with the Catholic church are significantly less likely to provide emergency contraception (Campbell & Bybee, 1997;Smugar, Spina, & Merz, 2000).…”